Pneumonia最新文献

{"title":"How low can we go? The implications of low bacterial load in respiratory microbiota studies.","authors":"Robyn L Marsh,&nbsp;Maria T Nelson,&nbsp;Chris E Pope,&nbsp;Amanda J Leach,&nbsp;Lucas R Hoffman,&nbsp;Anne B Chang,&nbsp;Heidi C Smith-Vaughan","doi":"10.1186/s41479-018-0051-8","DOIUrl":"https://doi.org/10.1186/s41479-018-0051-8","url":null,"abstract":"<p><strong>Background: </strong>Culture-independent sequencing methods are increasingly used to investigate the microbiota associated with human mucosal surfaces, including sites that have low bacterial load in healthy individuals (e.g. the lungs). Standard microbiota methods developed for analysis of high bacterial load specimens (e.g. stool) may require modification when bacterial load is low, as background contamination derived from sterile laboratory reagents and kits can dominate sequence data when few bacteria are present.</p><p><strong>Main body: </strong>Bacterial load in respiratory specimens may vary depending on the specimen type, specimen volume, the anatomic site sampled and clinical parameters. This review discusses methodological issues inherent to analysis of low bacterial load specimens and recommends strategies for successful respiratory microbiota studies. The range of methods currently used to process DNA from low bacterial load specimens, and the strategies used to identify and exclude background contamination are also discussed.</p><p><strong>Conclusion: </strong>Microbiota studies that include low bacterial load specimens require additional tests to ensure that background contamination does not bias the results or interpretation. Several methods are currently used to analyse the microbiota in low bacterial load respiratory specimens; however, there is scant literature comparing the effectiveness and biases of different methods. Further research is needed to define optimal methods for analysing the microbiota in low bacterial load specimens.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"10 ","pages":"7"},"PeriodicalIF":6.8,"publicationDate":"2018-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-018-0051-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36308737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung function in HIV-infected children and adolescents.","authors":"Leah N Githinji,&nbsp;Diane M Gray,&nbsp;Heather J Zar","doi":"10.1186/s41479-018-0050-9","DOIUrl":"https://doi.org/10.1186/s41479-018-0050-9","url":null,"abstract":"<p><strong>Background: </strong>The advent of antiretroviral therapy has led to the improved survival of human immunodeficiency virus (HIV)-infected children to adulthood and to HIV becoming a chronic disease in older children and adolescents. Chronic lung disease is common among HIV-infected adolescents. Lung function measurement may help to delineate the spectrum, pathophysiology and guide therapy for HIV-related chronic lung disease.</p><p><strong>Aim: </strong>The aim of this study was to review the available data on the spectrum and determinants of lung function abnormalities and the impact of antiretroviral therapy on lung function in perinatally HIV-infected children and adolescents.</p><p><strong>Methods: </strong>Electronic databases \"PUBMED\", \"African wide\" and \"CINAHL\" via EBSCO Host, using the MeSH terms \"Respiratory function\" AND \"HIV\" OR \"Acquired Immunodeficiency Syndrome\" AND \"Children\" OR \"Adolescents\", were searched for relevant articles on lung function in HIV-infected children and adolescents. The search was limited to English language articles published between January 1984 and September 2017.</p><p><strong>Results: </strong>Eighteen articles were identified, which included studies from Africa, the United States of America (USA) and Italy, representing 2051 HIV-infected children and adolescents, 68% on antiretroviral therapy, aged from 50 days to 24 years. Lung function abnormalities showed HIV-infected participants had increased irreversible lower airway expiratory obstruction and reduced functional aerobic impairment on exercise, compared to HIV-uninfected participants. Mosaic attenuation, extent of bronchiectasis, history of previous pulmonary tuberculosis or previous lower respiratory tract infection and cough for more than 1 month were associated with low lung function. Pulmonary function tests in children established on antiretroviral therapy did not show aerobic impairment and had less severe airway obstruction.</p><p><strong>Conclusion: </strong>There is increasing evidence that HIV-infected children and adolescents have high prevalence of lung function impairment, predominantly irreversible lower airway obstruction and reduced aerobic function.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"10 ","pages":"6"},"PeriodicalIF":6.8,"publicationDate":"2018-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-018-0050-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36294261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-protein immunoglobulin M responses to pneumococcus are not associated with aging.","authors":"Esther L German, Bahij Al-Hakim, Elena Mitsi, Shaun H Pennington, Jenna F Gritzfeld, Angie D Hyder-Wright, Antonia Banyard, Stephen B Gordon, Andrea M Collins, Daniela M Ferreira","doi":"10.1186/s41479-018-0048-3","DOIUrl":"10.1186/s41479-018-0048-3","url":null,"abstract":"<p><strong>Background: </strong>The incidence of community-acquired pneumonia and lower respiratory tract infection rises considerably in later life. Immunoglobulin M (IgM) antibody levels to pneumococcal capsular polysaccharide are known to decrease with age; however, whether levels of IgM antibody to pneumococcal proteins are subject to the same decline has not yet been investigated.</p><p><strong>Methods: </strong>This study measured serum levels and binding capacity of IgM antibody specific to the pneumococcal surface protein A (PspA) and an unencapsulated pneumococcal strain in serum isolated from hospital patients aged < 60 and ≥ 60, with and without lower respiratory tract infection. A group of young healthy volunteers was used as a comparator to represent adults at very low risk of pneumococcal pneumonia. IgM serum antibody levels were measured by enzyme-linked immunosorbent assay (ELISA) and flow cytometry was performed to assess IgM binding capacity. Linear regression and one-way analysis of variance (ANOVA) tests were used to analyse the results.</p><p><strong>Results: </strong>Levels and binding capacity of IgM antibody to PspA and the unencapsulated pneumococcal strain were unchanged with age.</p><p><strong>Conclusions: </strong>These findings suggest that protein-based pneumococcal vaccines may provide protective immunity in the elderly.</p><p><strong>Trial registration: </strong>The LRTI trial (LRTI and control groups) was approved by the National Health Service Research Ethics Committee in October 2013 (12/NW/0713). Recruitment opened in January 2013 and was completed in July 2013. Healthy volunteer samples were taken from the EHPC dose-ranging and reproducibility trial, approved by the same Research Ethics Committee in October 2011 (11/NW/0592). Recruitment for this study ran from October 2011 until December 2012. LRTI trial: (NCT01861184), EHPC dose-ranging and reproducibility trial: (ISRCTN85403723).</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"10 ","pages":"5"},"PeriodicalIF":8.5,"publicationDate":"2018-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36300162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between pre-hospital antibiotic therapy and subsequent in-hospital mortality in adults presenting with community-acquired pneumonia: an observational study.","authors":"Biswajit Chakrabarti,&nbsp;Dan Wootton,&nbsp;Steven Lane,&nbsp;Elizabeth Kanwar,&nbsp;Joseph Somers,&nbsp;Jacyln Proctor,&nbsp;Nancy Prospero,&nbsp;Mark Woodhead","doi":"10.1186/s41479-018-0047-4","DOIUrl":"https://doi.org/10.1186/s41479-018-0047-4","url":null,"abstract":"<p><strong>Background: </strong>The majority of patients with community acquired-pneumonia (CAP) are treated in primary care and the mortality in this group is very low. However, a small but significant proportion of patients who begin treatment in the community subsequently require admission due to symptomatic deterioration. This study compared patients who received community antibiotics prior to admission to those who had not, and looked for associations with clinical outcomes.</p><p><strong>Methods: </strong>This study analysed the Advancing Quality (AQ) Pneumonia database of patients admitted with CAP to 9 acute hospitals in the northwest of England over a 12-month period.</p><p><strong>Results: </strong>There were 6348 subjects (mean age 72 [SD 16] years; gender ratio 1:1) admitted with CAP, of whom 17% had been pre-treated with antibiotics. The in-hospital mortality was 18.6% for the pre-treatment group compared to 13.2% in the \"antibiotic naïve\" group (<i>p</i> < 0.001). On multivariate analysis, age, male gender and antibiotic pre-treatment were predictors of in-hospital mortality along with a history of cerebrovascular accident, congestive cardiac failure, dementia, renal disease and cancer. After adjustment for CURB-65 score, age, co-morbidities and pre-treatment with antibiotics remained as independent risk factors for in-hospital mortality (OR 1.43, 95% CI 1.19-1.71).</p><p><strong>Conclusion: </strong>CAP patients admitted to hospital were more likely to die during admission if they had received antibiotics for the same illness pre-admission. Future studies should endeavor to determine the mechanisms underlying this association, such as microbiological factors and the role of comorbidities. Patients hospitalized with CAP despite prior antibiotic treatment in the community require close monitoring.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"10 ","pages":"2"},"PeriodicalIF":6.8,"publicationDate":"2018-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-018-0047-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35957163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumococcal vaccination in older persons: where are we today?","authors":"Paul Van Buynder,&nbsp;Robert Booy","doi":"10.1186/s41479-017-0045-y","DOIUrl":"https://doi.org/10.1186/s41479-017-0045-y","url":null,"abstract":"<p><p>Disease due to <i>Streptococcus pneumoniae</i>, the pneumococcus, remains a major source of illness in older persons. Globally, it remains the most important pathogen in respiratory infection deaths. Conjugated pneumococcal vaccines are used extensively in national pediatric programs, whereas a polysaccharide vaccine is used in all age groups, but mainly in the elderly and for high-risk groups. Recent data from the Netherlands led to the licensing in many countries of conjugated pneumococcal vaccines for older persons. There are substantial differences in recommendations from various national immunization technical advisory groups, which owe at least as much to differing assessments of available studies as to differences in local epidemiology. This review examines those differences and proposes a way forward.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"10 ","pages":"1"},"PeriodicalIF":6.8,"publicationDate":"2018-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-017-0045-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35723034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rocking pneumonia.","authors":"Ger T Rijkers,&nbsp;Maria Rodriguez Gomez","doi":"10.1186/s41479-017-0043-0","DOIUrl":"https://doi.org/10.1186/s41479-017-0043-0","url":null,"abstract":"<p><p>Ever since Chuck Berry coined the term \"rocking pneumonia\" in his 1956 song \"Roll over Beethoven\", pneumonia has been mentioned frequently in modern blues and rock songs. We analyzed the lyrics of these songs to examine how various elements of pneumonia have been represented in popular music, specifically the cause of pneumonia, the risk groups, comorbidity (such as the boogie woogie flu), the clinical symptoms, and treatment and outcome. Up to this day, songwriters suggest that pneumonia is caused mainly by the cold and rain and that treatment is hardly possible, aside from a shot of rhythm and blues.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"9 ","pages":"18"},"PeriodicalIF":6.8,"publicationDate":"2017-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-017-0043-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35669301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic burden of community-acquired pneumonia among elderly patients: a Japanese perspective.","authors":"Keiko Konomura,&nbsp;Hideaki Nagai,&nbsp;Manabu Akazawa","doi":"10.1186/s41479-017-0042-1","DOIUrl":"https://doi.org/10.1186/s41479-017-0042-1","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to estimate the economic burden of community-acquired pneumonia (CAP) among elderly patients in Japan. In addition, the study evaluated the relationship between total treatment cost and CAP risk factors.</p><p><strong>Methods: </strong>An administrative database was searched for elderly patients (≥ 65 years old) who had pneumonia (ICD-10 code: J12-J18) and an antibiotic prescription between 1 June 2014 and 31 May 2015. The all-cause total healthcare costs of outpatient and inpatient CAP episodes were calculated.</p><p><strong>Results: </strong>This study evaluated data from 29,619 patients with CAP who experienced 14,450 outpatient CAP episodes and/or 20,314 inpatient CAP episodes. The mean ages were 77.5 ± 8.0 years and 81.5 ± 8.2 years among the outpatient and inpatient groups, respectively. The median treatment costs were US$346 (interquartile range: $195-551) per outpatient episode and US$4851 (interquartile range: $3313-7669) per inpatient episode. More severe cases had increased treatment costs at the treating hospitals. Male sex, diabetes, chronic obstructive pulmonary disease, and liver dysfunction were associated with increased total treatment costs, while dementia, dialysis, and rheumatism were associated with high costs of treating a CAP episode.</p><p><strong>Conclusions: </strong>The economic burden of CAP might be decreased by reducing the number of hospitalizations for mild CAP and the incidence of severe CAP. Therefore, preventative care (e.g. oral hygiene or pneumococcus vaccination) is recommended for patients with related risk factors, such as male sex, older age, diabetes, chronic obstructive pulmonary disease, liver dysfunction, rheumatism, dementia, or dialysis.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"9 ","pages":"19"},"PeriodicalIF":6.8,"publicationDate":"2017-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-017-0042-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35327577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report on a defective antibody response against pneumococcal serotype 9V in a patient with a single episode of pneumonia.","authors":"Diana van Kessel,&nbsp;Thijs Hoffman,&nbsp;Heleen van Velzen-Blad,&nbsp;Bob Meek,&nbsp;Suzan van Mens,&nbsp;Jan Grutters,&nbsp;Ger Rijkers","doi":"10.1186/s41479-017-0040-3","DOIUrl":"https://doi.org/10.1186/s41479-017-0040-3","url":null,"abstract":"<p><strong>Background: </strong>Patients with recurrent respiratory tract infections and an impaired response to pneumococcal polysaccharide vaccination are diagnosed with a specific antibody deficiency. In adult patients with pneumococcal pneumonia an impaired antibody response to the infecting pneumococcal serotype can sometimes be found. It is unknown whether these patients are unable to produce an adequate anti-polysaccharide antibody response to pneumococcal vaccination after recovery.</p><p><strong>Case presentation: </strong>The authors describe a case of invasive pneumonia caused by <i>Streptococcus pneumoniae</i> serotype 9V in a previously healthy 35-year-old female. This patient did not produce serotype-specific antibodies against the infecting serotype during disease. After pneumococcal polysaccharide vaccination 3 months after recovery, she responded adequately to most other pneumococcal serotypes, but still had no response to the infecting serotype 9V. However, after 9 years (and prior to pneumococcal-conjugate vaccination) normal antibody levels against 9V were found. These antibody levels further increased after pneumococcal-conjugate vaccination.</p><p><strong>Conclusion: </strong>The authors believe that this case is the first description of a temporary deficient response to the infecting pneumococcal serotype in adults, while other reports with similar observations all involved children.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"9 ","pages":"16"},"PeriodicalIF":6.8,"publicationDate":"2017-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-017-0040-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35594871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of pneumococcal carriage and the effect of the 13-valent pneumococcal conjugate vaccination in the Western Australian Aboriginal population.","authors":"Deirdre A Collins,&nbsp;Anke Hoskins,&nbsp;Thomas Snelling,&nbsp;Kalpani Senasinghe,&nbsp;Jacinta Bowman,&nbsp;Natalie A Stemberger,&nbsp;Amanda J Leach,&nbsp;Deborah Lehmann","doi":"10.1186/s41479-017-0038-x","DOIUrl":"https://doi.org/10.1186/s41479-017-0038-x","url":null,"abstract":"<p><strong>Background: </strong>The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced to prevent invasive pneumococcal disease (IPD) in Western Australian (WA) Aboriginal people in 2001. PCV13 replaced PCV7 in July 2011, covering six additional pneumococcal serotypes; however, IPD rates remained high in Aboriginal people in WA. Upper respiratory tract pneumococcal carriage can precede IPD, and PCVs alter serotype distribution.</p><p><strong>Methods: </strong>To assess the impact of PCV13 introduction, identify emerging serotypes, and assess risk factors for carriage, nasopharyngeal swabs and information on demographic characteristics, health, medication and living conditions from Aboriginal children and adults across WA from August 2008 to November 2014 were collected. Bacteria were cultured using selective media and pneumococcal isolates were serotyped by Quellung reaction. Risk factors were analysed by multivariable logistic regression.</p><p><strong>Results: </strong>One thousand five hundred swabs pre- and 1385 swabs post-PCV13 introduction were collected. Pneumococcal carriage was detected in 66.8% of children <5 years old and 53.2% of 5-14 year-olds post-PCV13, compared with pre-PCV13 prevalence of 72.2% and 49.4%, respectively. The prevalence of PCV13-non-PCV7 serotypes decreased in children <5 years old from 13.5% pre-PCV13 to 5.8% post-PCV13 (<i>p</i> < 0.01), and from 8.4% to 6.1% in children 5-14 years old (<i>p</i> > 0.05). The most common serotypes post-PCV13 were 11A (prevalence 4.0%), 15B (3.5%), 16F (3.5%), and 19F (3.2%). Risk of detection of pneumococcal carriage increased until age 12 months (odds ratio [OR] 4.19, 95% confidence interval [CI] 2.39-7.33), with nasal discharge (OR 2.49 [95% CI 2.00-3.09]), residence in a remote community (OR 2.21 [95% CI 1.67-2.92]) and household crowding (OR 1.36 [95% CI 1.11-1.67]). Recent antibiotic use was negatively associated with pneumococcal carriage (OR 0.48 [95% CI 0.33-0.69]). Complete resistance to penicillin was present among isolates of serotypes 19A (6.0%), 19F (2.3%) and non-serotypeable isolates (1.9%). Serotype 23F and newly emerged serotype 7B isolates showed high rates of resistance to cotrimoxazole, erythromycin and tetracycline (86.9%, 86.9%, 82.0%, respectively for 23F, 100.0%, 100.0% and 93.3% for 7B).</p><p><strong>Conclusion: </strong>Since PCV13 replaced PCV7, carriage of PCV13-non-PCV7 serotypes decreased significantly among children <5 years old, those most likely to have received PCV13, and to a lesser extent in older people. Known risk factors for carriage including crowding and young age remain in the Aboriginal population.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"9 ","pages":"14"},"PeriodicalIF":6.8,"publicationDate":"2017-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-017-0038-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35505007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to: Standardisation and evaluation of a quantitative multiplex real-time PCR assay for the rapid identification of Streptococcus pneumonia","authors":"Feroze A. Ganaie, V. Govindan, K. R. Ravi Kumar","doi":"10.1186/s41479-017-0034-1","DOIUrl":"https://doi.org/10.1186/s41479-017-0034-1","url":null,"abstract":"","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"9 1","pages":""},"PeriodicalIF":6.8,"publicationDate":"2017-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-017-0034-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65785941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}